| NPI | 1275682676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA159848) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: OR 8448) |
| 363A00000X Physician Assistant (Licence: OR PA159848) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2025-04-04 |