| NPI | 1699087866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60270946) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60270946) |
| 363AM0700X Physician Assistant, Medical (Licence: WI 2571-23) | |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2021-10-05 |