| NPI | 1043534142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60866658) |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other (Licence: OR AT-AT-10148406) |
| 363A00000X Physician Assistant (Licence: OR PA207993) | |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2022-02-22 |