NPI | 1477856649 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60620540) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA-879) |
Enumeration Date | 2010-12-10 |
Last Update Date | 2025-04-09 |