| NPI | 1427018068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 007051) |
| Additional Taxonomies | 171000000X Military Health Care Provider (Licence: WA PA10003523) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2017-10-20 |