NPI | 1548341738 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01064) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA01064) |
363AS0400X Physician Assistant, Surgical (Licence: OR PA01064) | |
Enumeration Date | 2006-10-17 |
Last Update Date | 2011-01-14 |