| NPI | 1699288621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61308684) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 008617) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2023-01-05 |