| NPI | 1396172557 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60862943) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA23283) | 
| Enumeration Date | 2013-10-02 | 
| Last Update Date | 2021-01-25 |