| NPI | 1710438734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60910005) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53871) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2021-04-28 |