| NPI | 1033699731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA204321) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2018-0057) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2024-03-13 |