| NPI | 1457866865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA7846) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA185614) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2021-01-12 |