| NPI | 1609128990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60892445) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2012-0047) |
| 363A00000X Physician Assistant (Licence: WA PA60892445) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2024-08-13 |