| NPI | 1295181121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61328324) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005400) |
| 363A00000X Physician Assistant (Licence: OR PA184002) | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2023-04-17 |