| NPI | 1275520066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA OA10000230) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60895931) |
| Enumeration Date | 2005-10-05 |
| Last Update Date | 2018-10-12 |