| NPI | 1144240615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA213386) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA23236) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-11-14 |