| NPI | 1306353537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60821431) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA TA.60822493) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2020-08-04 |