| NPI | 1831924794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61658562) |
| Enumeration Date | 2024-09-02 |
| Last Update Date | 2025-05-29 |