| NPI | 1821569088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA192388) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2020-11-05 |