| NPI | 1194918409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA pa10003545) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA00532) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2020-10-14 |