| NPI | 1467787598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-929) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60112494) |
| Enumeration Date | 2009-10-07 |
| Last Update Date | 2014-01-21 |