| NPI | 1215382031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60883650) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058197) |
| 363A00000X Physician Assistant (Licence: PA OA003779) | |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2019-03-20 |