| NPI | 1629408794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA171426) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA51282) |
| 363A00000X Physician Assistant (Licence: WA PA60631240) | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2021-03-25 |