| NPI | 1639507288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA167858) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51221) |
| Enumeration Date | 2013-10-17 |
| Last Update Date | 2023-08-30 |