| NPI | 1588836654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA174781) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: OR PA174781) |
| 363A00000X Physician Assistant (Licence: WI 2663) | |
| Enumeration Date | 2008-03-29 |
| Last Update Date | 2020-03-16 |