| NPI | 1871791699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA163381) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 1031913) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2016-01-13 |