| NPI | 1114966819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA00451) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 392031) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2017-01-23 |