NPI | 1497264451 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60797627) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60797627) |
363AS0400X Physician Assistant, Surgical (Licence: WA PA60797627) | |
Enumeration Date | 2017-09-21 |
Last Update Date | 2025-06-02 |