| NPI | 1356743744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60812224) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001005056) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2020-12-18 |