| NPI | 1902989288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA00797) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: OR PA00797) |
| 364SM0705X Clinical Nurse Specialist, Medical-Surgical (Licence: ID PA503) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2018-12-28 |