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 |