| NPI | 1639646128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60908087) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60908087) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2020-05-12 |