| NPI | 1952702318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 025211 PA10003782) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA 025211 PA10003782) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |