| NPI | 1578867842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60516096) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 5877) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2015-01-21 |