| NPI | 1780128264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61241654) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA0349) |
| Enumeration Date | 2016-12-18 |
| Last Update Date | 2022-09-28 |