| NPI | 1023410990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA174433) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2020-01-14 |