| NPI | 1851145395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61511218) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.PA.61511218) |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-04-29 |