| NPI | 1700334760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60881076) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: DC PA031270) |
| 363AM0700X Physician Assistant Medical (Licence: VA 0110-005436) | |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2021-11-08 |