NPI | 1235713934 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61627460) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-05-09 |
Last Update Date | 2025-08-06 |