| NPI | 1053959031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61541399) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA205750) |
| Enumeration Date | 2019-12-20 |
| Last Update Date | 2024-05-15 |