| NPI | 1215424122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA187342) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2021-05-27 |