| NPI | 1508859968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA218220) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NM PA2005-0004) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2025-07-09 |