| NPI | 1417362096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA189344) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54422) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2022-07-21 |