NPI | 1548510258 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60299966) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA PA60299966) |
Enumeration Date | 2012-09-11 |
Last Update Date | 2016-05-16 |