| NPI | 1326490269 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-89207) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA179347) |
| Enumeration Date | 2016-07-04 |
| Last Update Date | 2024-09-06 |