| NPI | 1861823643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA 60414715) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60414715) |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2019-03-10 |