| NPI | 1295346245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA213285) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PA213285) |
| 363A00000X Physician Assistant (Licence: OR PA213285) | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2025-07-10 |