| NPI | 1801584537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61522345) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61522345) |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2024-04-05 |