| 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 |