NPI | 1346626207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60648261) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 0004325) |
363A00000X Physician Assistant (Licence: WA OA.60577673) | |
Enumeration Date | 2015-08-03 |
Last Update Date | 2024-10-21 |