| NPI | 1609527068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61308534) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-2202) |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2022-07-14 |