| NPI | 1396099768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60292006) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA20120057) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2021-08-10 |