| NPI | 1346626207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA OA.60577673) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60648261) |
| 363A00000X Physician Assistant (Licence: CO 0004325) | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2021-03-25 |