| NPI | 1831165737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA01381) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 17306) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2021-10-15 |