| NPI | 1063956803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60871056) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0006322) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2018-07-31 |