| NPI | 1780862185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA171032) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA12129) |
| Enumeration Date | 2008-02-07 |
| Last Update Date | 2023-11-06 |