| NPI | 1497283717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA212437) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54474) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2022-09-14 |