| NPI | 1679909006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60668491) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 017002) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2021-05-10 |