| NPI | 1225209539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60343461) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1095) |
| 363A00000X Physician Assistant (Licence: VA 0110004088) | |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2014-04-24 |