| NPI | 1215398763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61180402) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058146) |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2022-07-07 |