| NPI | 1891805255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60600009) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009443) |
| 363A00000X Physician Assistant (Licence: OR 171585) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2019-07-15 |