| NPI | 1679713291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60741485) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR 152902) |
| Enumeration Date | 2009-02-22 |
| Last Update Date | 2023-05-25 |