| NPI | 1922037415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60162619) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 2979) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2010-07-13 |