| NPI | 1750001962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA217811) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2024-01-02 |