| NPI | 1932592995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60761450) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057435) |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2023-11-14 |