| NPI | 1932800398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 70095402) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA218212) |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2026-04-21 |