| NPI | 1841931425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61266771) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: WA PA61266771) |
| 363A00000X Physician Assistant (Licence: ID PA-2641) | |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2024-04-30 |