| 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 |