| NPI | 1992088991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60493062) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003672) |
| 363A00000X Physician Assistant (Licence: WA PA60493062) | |
| Enumeration Date | 2011-09-26 |
| Last Update Date | 2020-12-03 |