| NPI | 1700569944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61476193) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA217555) |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2025-08-14 |