| NPI | 1326220484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60270435) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000069A) |
| Enumeration Date | 2007-11-30 |
| Last Update Date | 2013-08-29 |