| NPI | 1245911999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA.PA.61435763) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA62774) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2023-07-26 |