| NPI | 1801331897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA213179) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2022-12-01 |