NPI | 1235420498 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60647762) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2011-04-22 |
Last Update Date | 2021-06-23 |