| NPI | 1134508021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60577177) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50004294) |
| Enumeration Date | 2015-05-25 |
| Last Update Date | 2021-06-16 |