NPI | 1427584077 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA184665) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: WA PA60936449) | |
Enumeration Date | 2017-05-02 |
Last Update Date | 2021-12-07 |