| NPI | 1700521713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61578744) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115936) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2025-04-14 |