| NPI | 1619348786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA OA60900428) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60602163) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60602163) | |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2021-05-19 |