| NPI | 1457369951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10005378) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50001316) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2009-03-16 |