| NPI | 1396394292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1998) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA2307430) |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2025-11-24 |