| NPI | 1669402962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: WA PA60558414) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR MG1163461) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-12-03 |