NPI | 1285816264 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA10005303) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA10332) |
Enumeration Date | 2007-11-30 |
Last Update Date | 2019-04-29 |