| NPI | 1609304609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA192568) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2019-05-15 |