| NPI | 1184179160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60683787) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 24385) |
| Enumeration Date | 2016-08-19 |
| Last Update Date | 2023-07-03 |