| NPI | 1043823792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.PA.61593122) |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2025-01-13 |