| NPI | 1730341124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053425) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA195233) |
| Enumeration Date | 2008-06-27 |
| Last Update Date | 2021-12-14 |