NPI | 1417686684 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61448964) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61448964) |
Enumeration Date | 2022-06-05 |
Last Update Date | 2024-08-15 |