| NPI | 1881709038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 5173269-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60002097) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2011-11-10 |