| NPI | 1528372380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA152660) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA152660) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2022-03-06 |