| NPI | 1750797270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA186396) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60881550) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2021-12-21 |