| NPI | 1396149753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60511982) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.60511982) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2021-04-27 |