| NPI | 1164979894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1421) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR pa179953) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-09-11 |
| Last Update Date | 2023-11-14 |