| NPI | 1477256204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA214527) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61423634) |
| 363A00000X Physician Assistant (Licence: OR PA214527) | |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2024-05-08 |