| NPI | 1275877599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 57708) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60636778) |
| 363A00000X Physician Assistant (Licence: MD C0004962) | |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60636778) | |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2020-10-26 |