| NPI | 1316604697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA213562) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA60395) |
| Enumeration Date | 2021-11-22 |
| Last Update Date | 2023-01-25 |