| NPI | 1891342754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: WA PA61222914) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2019-08-24 |
| Last Update Date | 2024-05-24 |