| NPI | 1790157998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA217986) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60779867) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2024-02-02 |