| NPI | 1245740315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 1245740315) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 10522819-1206) |
| 363A00000X Physician Assistant (Licence: WA OA60822570) | |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2023-08-09 |