| NPI | 1326216003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA 60128518) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 2559) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2021-05-18 |