| NPI | 1205801289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001000295) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA218014) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2024-01-08 |