NPI | 1184191629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60932420) |
Enumeration Date | 2018-11-01 |
Last Update Date | 2024-09-16 |