| NPI | 1912018722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60184588) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| 363A00000X Physician Assistant (Licence: CA 1912018722) | |
| 363A00000X Physician Assistant (Licence: ND PAC0410) | |
| 363A00000X Physician Assistant (Licence: CA PA17764) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-09-07 |