| NPI | 1871191239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA208700) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA61114824) |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2022-08-24 |