| NPI | 1487771721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA179535) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0001462) |
| 363A00000X Physician Assistant (Licence: WA PA60599711) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2016-09-08 |