| NPI | 1144638453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SD 1087) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60485695) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2024-02-06 |