| NPI | 1447754767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA224228) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2018009238) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2025-06-09 |