| NPI | 1912446543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60797617) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601012443) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2024-09-16 |