NPI | 1932925658 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61618587) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.PA.61618587) |
Enumeration Date | 2024-11-26 |
Last Update Date | 2025-05-29 |