| NPI | 1003951799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60085936) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA01762) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2021-03-01 |