| NPI | 1457751802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1839) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA169153) |
| 363A00000X Physician Assistant (Licence: OR PG170101) | |
| Enumeration Date | 2014-09-03 |
| Last Update Date | 2023-02-08 |