NPI | 1922473388 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60740912) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1329) |
Enumeration Date | 2015-12-09 |
Last Update Date | 2024-12-18 |