| NPI | 1255547782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA00971) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004214) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |