| NPI | 1801382361 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61071777)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55775)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-07-09 | 
| Last Update Date | 2021-03-11 |