| NPI | 1518968403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: AK 759) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA PA61298356) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2023-07-17 |