| NPI | 1174796528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA150424) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA150424) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2021-02-09 |