| NPI | 1427579796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60892394) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12415) |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2020-06-02 |