| NPI | 1992782957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60024900) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2005-0036) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2010-11-02 |