| NPI | 1194092890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-951) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA195229) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2024-05-14 |