| NPI | 1497807663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA10004675) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50-00-1199) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2007-07-08 |