| NPI | 1740516053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA150326) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363A00000X Physician Assistant (Licence: OR PA150326) | |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2020-12-23 |