| NPI | 1700218534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60384344) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA159145) |
| Enumeration Date | 2013-08-03 |
| Last Update Date | 2023-09-20 |