| NPI | 1679704498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60147977) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085003522) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2021-06-08 |