| NPI | 1881106136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-80661) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA184882) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2025-04-10 |