| NPI | 1386364768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA217770) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PA217770) |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2023-12-13 |