| NPI | 1770850570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60514733) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AK 1127) |
| Enumeration Date | 2011-11-22 |
| Last Update Date | 2015-12-21 |