| NPI | 1720711401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61279236) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA209180) |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2024-10-10 |