| NPI | 1003873142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 569-023) |
| 363AS0400X Physician Assistant, Surgical (Licence: WI 569-023) | |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2015-06-01 |