| NPI | 1043748148 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-159791) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60975699) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2025-07-11 |