| NPI | 1982854543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60240558) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 7126427-1206) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2011-10-25 |