| NPI | 1982955779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60688508) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-988) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2025-07-09 |