NPI | 1477973204 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA168821) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA61075846) |
363AM0700X Physician Assistant, Medical (Licence: OR PA168821) | |
Enumeration Date | 2014-04-19 |
Last Update Date | 2022-07-29 |