| NPI | 1477052470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA185332) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55241) |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2023-01-09 |