| NPI | 1487272134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA 61594812) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 025416) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2025-03-10 |