| NPI | 1831803568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA214629) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: VA 1180781) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2023-12-19 |