NPI | 1821332255 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA160128) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 160128) |
Enumeration Date | 2012-11-26 |
Last Update Date | 2020-12-30 |