| NPI | 1114167830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60255470) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA pa60255470) |
| Enumeration Date | 2009-02-21 |
| Last Update Date | 2020-12-31 |