| NPI | 1881146645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA213247) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6529) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2023-08-23 |