| NPI | 1235594896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA 180390) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA 60705018) |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2016-12-01 |