| 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 |