| NPI | 1508134891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61160822) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MT 117153) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2022-11-01 |