| NPI | 1982239117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61079185) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61079185) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2021-02-01 |