| NPI | 1700069408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA153130) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: HI AMD-330) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2021-02-16 |