| NPI | 1700375482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA70007583) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: WA PA70007583) |
| 171000000X Military Health Care Provider | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-11442) | |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2026-06-03 |