NPI | 1588670020 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA10001525) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10001525) |
363AS0400X Physician Assistant, Surgical (Licence: WA PA10001525) | |
Enumeration Date | 2006-08-01 |
Last Update Date | 2011-06-24 |