| NPI | 1467438762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10005154) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA703) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2021-04-05 |