| NPI | 1629730502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA.PA.70094994) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WA DIET.DI.61590015) |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2026-03-23 |