| NPI | 1629635008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA207931) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 58259) |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2023-03-20 |