| NPI | 1477586733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA167150) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 611) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2022-04-26 |