| NPI | 1649368580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA161432) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010648) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2025-05-15 |