| NPI | 1538300256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10005318) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GU PA000073) |
| Enumeration Date | 2009-03-09 |
| Last Update Date | 2019-01-29 |