| NPI | 1619290863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA157314) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 20780) |
| Enumeration Date | 2010-03-02 |
| Last Update Date | 2012-05-31 |