| NPI | 1225426505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT 76393) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60531804) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2021-11-09 |