| NPI | 1972762920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 60152518) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2008007033) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2021-05-11 |