| NPI | 1801515028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61470216) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: WA PA61470216) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2023-11-17 |