| NPI | 1003029950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60921533) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 2055) |
| 363A00000X Physician Assistant (Licence: OR PA174313) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2023-01-25 |