| NPI | 1073132916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61521364) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010204) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2025-08-21 |