| NPI | 1922301308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA215327) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KS 1501413) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2024-04-12 |