| NPI | 1811595499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61114586) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC 3749) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2021-03-11 |