| NPI | 1851987929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61199179) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1953) |
| Enumeration Date | 2020-12-14 |
| Last Update Date | 2021-12-20 |