NPI | 1003430935 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61035868) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 61035868) |
Enumeration Date | 2020-06-06 |
Last Update Date | 2021-10-25 |