| NPI | 1962739508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA 60118213) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WA TA60118207) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2016-09-27 |