| NPI | 1932496296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60539003) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006167) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2015-04-15 |