| NPI | 1992129381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60547632) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2350) |
| Enumeration Date | 2014-02-06 |
| Last Update Date | 2021-04-29 |