NPI | 1548506918 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60321732) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60321732) |
Enumeration Date | 2012-12-12 |
Last Update Date | 2015-11-25 |