| NPI | 1346243524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA180691) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 004413) |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2018-07-24 |