| NPI | 1063991511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61564579) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55981) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2024-12-11 |