| NPI | 1972099422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60870359) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2023-12-07 |