| NPI | 1720472491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60701011) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60701011) |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2024-09-19 |