| NPI | 1952703258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60613322) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA 3902000X) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: ID 3902000X) | |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2016-02-23 |