| NPI | 1013311547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 7338) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61143894) |
| Enumeration Date | 2014-10-13 |
| Last Update Date | 2023-10-24 |