| NPI | 1992957393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61673963) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05841) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2025-07-02 |