| NPI | 1255858981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60793707) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010897) |
| Enumeration Date | 2017-08-24 |
| Last Update Date | 2023-07-11 |