| NPI | 1881621381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01323) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 280) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2019-12-02 |