| NPI | 1710433859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA MS6827680) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1739) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2025-07-25 |