| NPI | 1851315329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60337595) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH PA00940) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2023-03-28 |