| NPI | 1356507628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA225046) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51600) |
| 363A00000X Physician Assistant (Licence: CO 2619) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2025-09-04 |