| NPI | 1497170005 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61473287)  | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 55380)  | 
| Enumeration Date | 2014-02-19 | 
| Last Update Date | 2024-03-20 |