| NPI | 1659349355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA10004408) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004408) |
| 363AM0700X Physician Assistant, Medical (Licence: CA P17464) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA 9104030) | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2018-03-17 |