NPI | 1619629425 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61328454) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-01-23 |
Last Update Date | 2023-02-02 |