| NPI | 1619165222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10005088) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011695) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2021-06-22 |