| NPI | 1841075454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61485607) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2024-05-13 |