| NPI | 1740062991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA223585) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA223585) |
| Enumeration Date | 2023-10-20 |
| Last Update Date | 2025-04-09 |