| NPI | 1922416858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60702543) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C05451) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2018-08-08 |