| NPI | 1528492592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA.60543660) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5472) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2015-09-17 |