| NPI | 1164745949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60592113) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20842) |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2021-05-25 |