| NPI | 1265493399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR pa151129) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10003271) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2017-02-10 |