| NPI | 1457699928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1011) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA161502) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2014-04-10 |