| 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 |