| NPI | 1013241884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 8428) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: AZ 8428) |
| 363A00000X Physician Assistant (Licence: AZ 8428) | |
| 363A00000X Physician Assistant (Licence: WA PA60115662) | |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60115662) | |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2021-09-07 |