| NPI | 1821783572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA215967) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2024-09-13 |