| NPI | 1518395763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60427963) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1132) |
| Enumeration Date | 2013-10-25 |
| Last Update Date | 2017-06-22 |