| NPI | 1285304378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA218816) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-2090) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2021-09-20 |
| Last Update Date | 2024-12-13 |