| NPI | 1215262464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 61016661) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9104962) |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2025-04-08 |