| NPI | 1619968187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA00743) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10005231) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2016-03-25 |