| NPI | 1558307678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA150192) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10004991) |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2023-12-05 |