| NPI | 1760852545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61263669) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 9541054-1206) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2022-09-21 |