NPI | 1245749613 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60993199) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA219330) |
Enumeration Date | 2017-09-28 |
Last Update Date | 2025-09-18 |