| NPI | 1386074375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA179564) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA056218) |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2022-01-13 |