| NPI | 1518305754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61352821) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2023-01-09 |