| NPI | 1427562487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60828342) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6991) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60828342) | |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 6991) | |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 6991) | |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA60828342) | |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2020-07-16 |