| NPI | 1487925541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60510262) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA164994) |
| Enumeration Date | 2012-01-21 |
| Last Update Date | 2015-02-03 |