| NPI | 1497921100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA191220) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011562) |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2021-02-23 |