| NPI | 1487908786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61202127) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1022) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2022-05-12 |