| NPI | 1487286597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61445565) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-007348) |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2023-09-20 |