| NPI | 1285979138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA164959) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5318) |
| 363A00000X Physician Assistant (Licence: OR PA164969) | |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2025-12-10 |