| NPI | 1396103032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA MW5580281) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019459) |
| Enumeration Date | 2016-02-09 |
| Last Update Date | 2020-01-08 |