| NPI | 1699729509 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10005224) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 1082) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2010-10-29 |