| NPI | 1346649282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60630676) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2589) |
| Enumeration Date | 2014-08-16 |
| Last Update Date | 2021-03-31 |