| NPI | 1386613883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA204268) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 6382) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-03-16 |
| Last Update Date | 2024-12-18 |