| NPI | 1023304870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60638457) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1578) |
| 363A00000X Physician Assistant (Licence: MN 10974) | |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2016-08-08 |