| NPI | 1902055619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA150050) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2022-04-14 |