| NPI | 1558870022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60932126) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021385) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2022-10-25 |