| NPI | 1083967020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA160520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA160520) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2025-08-22 |