| NPI | 1518449560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA197542) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-09-05 |
| Last Update Date | 2020-03-06 |