| NPI | 1730430380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60310348) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58323) |
| Enumeration Date | 2012-09-23 |
| Last Update Date | 2022-09-06 |