| NPI | 1790203255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60906450) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: WA 60906450) |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA60906450) | |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2023-11-03 |