| NPI | 1104640804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA.61677443) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA18840) |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2026-05-20 |