| NPI | 1740394972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 268114-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10003282) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-07-22 |