| NPI | 1366911604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60920872) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 1155890) |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2023-07-19 |