| NPI | 1417226382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA184560) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55040) |
| 363A00000X Physician Assistant (Licence: MN 1645) | |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2024-03-09 |