| NPI | 1699061812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60989471) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003606) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2020-12-08 |