| NPI | 1629353347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA220995) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21899) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2024-10-21 |