| NPI | 1477026342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61309256) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 1155141) |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2023-01-04 |