| NPI | 1376917013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA0005823) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005823) |
| 261QR1300X Clinic/Center, Rural Health (Licence: WA PA60611259) | |
| 363A00000X Physician Assistant (Licence: WA PA60611259) | |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2026-04-07 |