| NPI | 1245535632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60197705) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2025-02-05 |