| NPI | 1306343728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60871024) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1645) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2021-09-24 |