| NPI | 1669910758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61254283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 181243) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2022-04-14 |