| NPI | 1538334743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60001076) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3382) |
| Enumeration Date | 2008-04-29 |
| Last Update Date | 2012-09-25 |