| NPI | 1215982517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA100004753) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA155112) |
| 363A00000X Physician Assistant (Licence: WA PA10004753) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2011-10-31 |