| NPI | 1568856458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13187) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60542587) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2024-02-12 |