NPI | 1881108231 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA206830) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA61158299) |
Enumeration Date | 2017-11-21 |
Last Update Date | 2024-11-04 |