| NPI | 1568569143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA WA PA10003566) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA01380) |
| Enumeration Date | 2006-09-17 |
| Last Update Date | 2015-12-18 |