| NPI | 1770744625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: WA PA61042361) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 60062911) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2020-07-17 |