| NPI | 1073156048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 61614652) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA58155) |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2024-12-30 |