| NPI | 1255324695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10003978) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1435) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2021-04-29 |