| NPI | 1699734335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: UT 5610243-1206) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WA PA10005007) |
| 363A00000X Physician Assistant (Licence: WA PA10005007) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2022-01-04 |