| NPI | 1801123476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AK 772) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60095663) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2023-03-07 |