| NPI | 1598196644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2452) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60586983) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2021-06-08 |