| NPI | 1871918011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06342) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA166412) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2021-10-18 |