| NPI | 1205196524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61417845) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA22278) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2023-07-19 |