| NPI | 1841771870 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61025225) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61025225) | 
| Enumeration Date | 2018-08-28 | 
| Last Update Date | 2023-04-25 |