| NPI | 1801461132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61175602) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-10-04 |