| NPI | 1356331060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA162456) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3180) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2022-10-11 |