| NPI | 1942500541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK PADA996) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60188305) |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2016-12-12 |