| NPI | 1134419989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5009) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA 60212606) |
| Enumeration Date | 2011-04-13 |
| Last Update Date | 2023-01-10 |