| NPI | 1689745317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60015360) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 2078) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2011-01-11 |