| NPI | 1467832055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60569930) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601009168) |
| Enumeration Date | 2015-06-09 |
| Last Update Date | 2023-11-27 |