NPI | 1902535180 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61412070) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE PENDING) |
Enumeration Date | 2022-06-06 |
Last Update Date | 2023-05-26 |