| NPI | 1831127646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA21918) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10005041) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2012-03-15 |