| NPI | 1326405812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61099023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.004581RX) |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2024-03-28 |