| NPI | 1538459599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA167677) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006077) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2022-07-21 |