| NPI | 1801124631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60122087) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2009-12-07 |
| Last Update Date | 2011-02-04 |