NPI | 1104022185 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA00611) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: OR PA00611) |
Enumeration Date | 2007-06-26 |
Last Update Date | 2020-08-10 |