| NPI | 1821653254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA202793) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 58813) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2024-09-30 |