| NPI | 1205148434 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60119966) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-851) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2014-07-21 |