| NPI | 1053869636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12279) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60702355) |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2023-01-30 |