| NPI | 1821048281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA197307) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NM PA2005-0033) |
| 363A00000X Physician Assistant (Licence: OR PA181738) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2020-11-04 |