| NPI | 1871114645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA61187952) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.PA.61187952) |
| Enumeration Date | 2020-05-02 |
| Last Update Date | 2024-12-30 |