NPI | 1518238666 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA165781) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA165781) |
Enumeration Date | 2012-01-21 |
Last Update Date | 2023-02-15 |