| NPI | 1902463862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61126886) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61126886) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2024-12-16 |