| NPI | 1548990799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2368) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA214177) |
| Enumeration Date | 2022-06-12 |
| Last Update Date | 2024-09-09 |