| NPI | 1093311912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA201174) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61083326) |
| 363AM0700X Physician Assistant, Medical (Licence: WA 61083326) | |
| Enumeration Date | 2020-12-07 |
| Last Update Date | 2025-02-11 |