NPI | 1750810602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60948577) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2017-06-05 |
Last Update Date | 2019-11-06 |