| NPI | 1780053793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60698227) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60698227) |
| Enumeration Date | 2015-09-20 |
| Last Update Date | 2022-08-11 |