| NPI | 1457778151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60799608) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51505) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2014-03-20 |
| Last Update Date | 2020-04-07 |