| NPI | 1952678401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60248549) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03246) |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2013-10-04 |