| NPI | 1093811663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10003302) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR OR PA00484) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2022-11-30 |