| NPI | 1134168875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60082334) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0108408512) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2010-08-10 |