| NPI | 1699841114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2006-0049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60745146) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2017-05-12 |