| NPI | 1801986757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8182) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004404) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2021-02-02 |