| NPI | 1306365531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61447074) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 21530) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2023-08-07 |