| NPI | 1114511169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA213206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 213206) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-02-21 |
| Last Update Date | 2025-06-26 |