| NPI | 1427400290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA178313) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT Med-PAC-Lic-69117) |
| 363A00000X Physician Assistant (Licence: CA PA58424) | |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2022-11-16 |