| NPI | 1841420122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60521692) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CT 002276) |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2015-04-20 |