| NPI | 1295037042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60583196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014388) |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2020-12-30 |