| NPI | 1568471357 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA 10004236) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CO 2073) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2011-02-23 |