| NPI | 1073860979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: WA PA60527239) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA22431) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2015-12-29 |