| NPI | 1629510888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60710653) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2025-05-21 |