| NPI | 1447580907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61113677) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 013811) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2021-11-08 |