| NPI | 1730584483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60518901) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60518901) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2021-05-10 |