| NPI | 1396737706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60168389) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA338) |
| 363A00000X Physician Assistant (Licence: NV PA1392) | |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2017-01-04 |