| NPI | 1487679502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60043087) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0003078) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2012-03-20 |