| NPI | 1518450931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA00517) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2018-06-16 |