| NPI | 1982346425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA.PA.70161654) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA.PA.70161654) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2026-10-05 |