| NPI | 1821564360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61144771) |
| Additional Taxonomies | 208800000X Urology (Licence: NV PA2037) |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2021-11-30 |