| NPI | 1881169365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61098708) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: AZ 7266) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2024-10-15 |