| NPI | 1245414978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01337) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22873) |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2016-05-25 |