| NPI | 1316534597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61413217) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0011606) |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2023-12-22 |