| NPI | 1366909673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61195747) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA PA6741) |
| 363A00000X Physician Assistant (Licence: WA PA61195747) | |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2021-12-07 |