| NPI | 1649466376 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10004520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 005165) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2022-11-09 |