| NPI | 1881675015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60413586) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9102446) |
| Enumeration Date | 2005-11-05 |
| Last Update Date | 2015-02-20 |