| NPI | 1740623099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2569) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA168556) |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2021-01-25 |