| NPI | 1114060746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA00607) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PA00607) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2018-04-03 |