| NPI | 1750425690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA10005178) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA14926) |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2021-03-01 |