| NPI | 1538587795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA165109) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2021-02-08 |