| NPI | 1417259060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60188676) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA-880) |
| Enumeration Date | 2010-12-01 |
| Last Update Date | 2021-03-30 |