NPI | 1972021434 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60796422) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: WA PA60796422) | |
Enumeration Date | 2017-09-05 |
Last Update Date | 2020-10-26 |