| NPI | 1528477817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA185646) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 007273) |
| Enumeration Date | 2014-08-12 |
| Last Update Date | 2018-03-17 |