| NPI | 1780781500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MT 532) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA PA10004623) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-07-26 |