| NPI | 1679594121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10004116) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10004116) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2010-02-25 |