NPI | 1194103176 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60734980) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA179365) |
Enumeration Date | 2015-05-11 |
Last Update Date | 2018-03-17 |