| NPI | 1659472504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 2238) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60397158) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2025-01-10 |