| NPI | 1811217078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA151672) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR PA151672) |
| Enumeration Date | 2010-06-10 |
| Last Update Date | 2024-07-25 |