| NPI | 1700504842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61455394) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA PA61455394) |
| Enumeration Date | 2022-08-15 |
| Last Update Date | 2024-11-11 |