| NPI | 1417027442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01544) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10003820) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2015-04-24 |