| NPI | 1780802801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA207689) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7537) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2021-12-14 |