| NPI | 1417508045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112583) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61092040) |
| 363A00000X Physician Assistant (Licence: OR PA201602) | |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2024-12-06 |