| NPI | 1023165362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA180692) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010759) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-03-07 |