| NPI | 1356968390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60185104) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61085104) |
| Enumeration Date | 2020-06-25 |
| Last Update Date | 2023-03-24 |