| NPI | 1477724060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60471575) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 504) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2021-04-27 |