| NPI | 1912068321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PT61113758) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 63441) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2021-10-25 |