| NPI | 1528065265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OA10000209) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA PA10004350) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2007-07-08 |