| NPI | 1548832744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA221253) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA59702) |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2024-09-15 |