| NPI | 1396040770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60328816) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA160675) |
| Enumeration Date | 2011-01-17 |
| Last Update Date | 2013-01-22 |