| NPI | 1437527520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA184784) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 1145279) |
| 363A00000X Physician Assistant (Licence: OR PA184784) | |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2020-12-30 |