| NPI | 1518448463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA218445) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7179) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2024-04-16 |