| NPI | 1851607337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60806023) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.003769) |
| 363A00000X Physician Assistant (Licence: CA 54041) | |
| Enumeration Date | 2010-08-23 |
| Last Update Date | 2018-01-02 |