| NPI | 1861778649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60278090) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA PA.200449) |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2024-08-29 |