| NPI | 1629574645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60852435) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2019-10-07 |