| NPI | 1427421965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60705172) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC434) |
| Enumeration Date | 2015-11-05 |
| Last Update Date | 2021-01-25 |