| NPI | 1679122394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA.PA.70059773) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA.PA.70059773) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2026-07-20 |