| NPI | 1740503994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60565196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60565196) |
| 363A00000X Physician Assistant (Licence: VA 0110003254) | |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2022-10-25 |