| NPI | 1871716811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA10004224) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA00973) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2015-11-11 |