| NPI | 1558778712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61035763) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0003942) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2021-09-24 |