| NPI | 1831591072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: WA PA60610421) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60610421) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2015-12-10 |