| NPI | 1255954277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA211194) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PA211194) |
| 363AM0700X Physician Assistant, Medical (Licence: OR PA211194) | |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2023-12-05 |