| NPI | 1831170158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA10004588) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA PA0004588) |
| Enumeration Date | 2005-11-14 |
| Last Update Date | 2015-07-10 |