| NPI | 1285211946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61344725) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14095) |
| Enumeration Date | 2021-03-26 |
| Last Update Date | 2022-10-28 |