| NPI | 1154373868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01167) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051778) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2013-04-25 |