| NPI | 1467851600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA169942) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60719666) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2021-10-13 |