| NPI | 1760715312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA166658) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60108219) |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2024-12-09 |