| NPI | 1871971234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA179810) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60705470) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2018-02-09 |