| NPI | 1093372070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61274889) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2019-0048) |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2023-01-05 |