| NPI | 1518187764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 7441125-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10005136) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2009-10-06 |