| NPI | 1841749405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA188758) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA188758) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2020-12-23 |