| NPI | 1851945539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116056) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61111335) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2023-08-15 |