| NPI | 1548410616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA168009) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19923) |
| 363A00000X Physician Assistant (Licence: WA PA60694076) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2023-09-20 |