| NPI | 1851060149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61644949) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-2389) |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2025-09-10 |