| NPI | 1346772563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61012220) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3801) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2020-01-08 |