| NPI | 1477613214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA10005098) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10005098) |
| 363A00000X Physician Assistant (Licence: OR PA01465) | |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2013-10-18 |