| NPI | 1649521188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60569926) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4385) |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2021-04-29 |