| NPI | 1679573265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60157540) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 2643) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2010-11-15 |