| NPI | 1821360934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60666873) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV PA1318) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60666873) | |
| Enumeration Date | 2012-02-04 |
| Last Update Date | 2020-03-03 |