| NPI | 1528523719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61224178) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3801) |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2024-10-08 |