| NPI | 1215488572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109915) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60953869) |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2022-10-24 |