| NPI | 1851550784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10005327) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 6825343-1206) |
| 363A00000X Physician Assistant (Licence: UT 6825343-8906) | |
| 363A00000X Physician Assistant (Licence: PA MA053252) | |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2013-11-08 |