| NPI | 1053082404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA207125) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 67941) |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2026-06-30 |