| NPI | 1932504115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA216285) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60511314) |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2023-08-09 |