| NPI | 1053770271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60922855) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109276) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2021-08-17 |