| NPI | 1154408631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60259472) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA-967) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2012-06-11 |