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 |