| NPI | 1689993255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA185957) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV pa0341) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2018-01-26 |