| NPI | 1740757350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60913569) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PA189479) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2024-12-24 |