| NPI | 1063960268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA60336) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA188794) |
| 363AM0700X Physician Assistant, Medical (Licence: OR PA188794) | |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2024-10-16 |