| NPI | 1225209851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60973755) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004440) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2020-02-26 |