| NPI | 1326586926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA1904345) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61377576) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2025-05-08 |