| NPI | 1043237134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10005223) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 502) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2021-06-16 |