| NPI | 1215397641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: WA PA60640191) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 2008025240) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2016-04-01 |