| NPI | 1013007822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10003924) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-42399) |
| 363A00000X Physician Assistant (Licence: AK 1117) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2016-03-17 |