| NPI | 1154712933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA186341) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52295) |
| 363A00000X Physician Assistant (Licence: WA PA61234461) | |
| Enumeration Date | 2015-02-14 |
| Last Update Date | 2022-03-24 |