| NPI | 1174024400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA211899) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL 9111097) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9111097) | |
| Enumeration Date | 2018-02-22 |
| Last Update Date | 2023-04-21 |