| NPI | 1013997899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60494105) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0002219) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2014-09-22 |