| NPI | 1659883627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA189577) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60788200) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2018-08-31 |