| NPI | 1255981189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61118633) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA PA61118633) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2021-04-26 |