| NPI | 1720402688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61229708) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 072097) |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2024-05-13 |