| NPI | 1851686901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09187) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 161470) |
| 363A00000X Physician Assistant (Licence: WA 60371258) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2023-05-31 |