| NPI | 1871604819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA213699) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA18140) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2023-01-09 |