| NPI | 1568760551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA176646) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21444) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2021-09-29 |