| NPI | 1215707591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA227573) |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2025-10-08 |