| NPI | 1891805511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA00337) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA10003290) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |