| NPI | 1801334248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 61081973) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 11105298-1206) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2020-08-27 |