| NPI | 1346259439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10003144) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 00508) |
| 363AM0700X Physician Assistant, Medical (Licence: WA 10003144) | |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2018-06-29 |