| NPI | 1699737601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 781) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA 10003659) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2012-12-06 |