| NPI | 1780292466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61227136) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61227136) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2023-05-02 |