NPI | 1114229374 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60346640) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA153162) |
Enumeration Date | 2010-11-21 |
Last Update Date | 2018-05-02 |