| NPI | 1285076810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 002429) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60790011) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2021-01-12 |