NPI | 1790181543 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: WA PA61004862) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61004862) |
Enumeration Date | 2014-11-06 |
Last Update Date | 2023-02-09 |