| NPI | 1194436766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA214284) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2023-02-13 |