NPI | 1316496011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61134073) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61134073) |
Enumeration Date | 2016-09-23 |
Last Update Date | 2024-06-25 |