| NPI | 1710302831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA 60421675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56888) |
| 363A00000X Physician Assistant (Licence: UT 12886344-1206) | |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2025-01-26 |