| NPI | 1497751515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA1103) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA01103) |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2015-06-10 |