NPI | 1497901672 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61004268) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA61004268) |
363AS0400X Physician Assistant, Surgical (Licence: WA PA61004268) | |
Enumeration Date | 2008-08-07 |
Last Update Date | 2025-06-04 |