NPI | 1770790602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60225033) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 004270) |
367H00000X Anesthesiologist Assistant (Licence: GA 004270) | |
Enumeration Date | 2007-05-17 |
Last Update Date | 2021-05-12 |