| NPI | 1740892298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61230506) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA 61230506) |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2024-12-09 |