| NPI | 1225434798 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA174934) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA59660) |
| Enumeration Date | 2014-11-11 |
| Last Update Date | 2023-11-03 |