| NPI | 1922192764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA00799) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2011-03-15 |