| NPI | 1023664844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 363A00000X Physician Assistant (Licence: WA PA61098760) | |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2024-05-13 |