| NPI | 1851361646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60115) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60162546) |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA60162546) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2022-02-03 |