| NPI | 1669987426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA191992) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55201) |
| Enumeration Date | 2017-12-02 |
| Last Update Date | 2022-03-15 |