| NPI | 1538492319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA179141) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21554) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2023-07-05 |