| NPI | 1962738955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA pa.60168372) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VA 0110003138) |
| 363AM0700X Physician Assistant, Medical (Licence: WA pa.60168372) | |
| 363AS0400X Physician Assistant, Surgical (Licence: WA pa.60168372) | |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2021-03-31 |