| NPI | 1568452720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA00752) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: OR PA00752) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2023-07-26 |