| NPI | 1689666844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA211179) |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2026-05-09 |