| NPI | 1376564203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR LL15829) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA01106) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2010-12-30 |