| NPI | 1326395849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60722879) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07838) |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2018-08-23 |