| NPI | 1336601483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA211536) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 57578) |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2022-09-23 |