| NPI | 1528553682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA215067) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114907) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA059838) | |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2024-03-13 |