| NPI | 1568935476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60902500) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID 9771658) |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2025-07-24 |