| NPI | 1457637860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA159795) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA4277) |
| Enumeration Date | 2011-10-30 |
| Last Update Date | 2013-10-31 |