| NPI | 1942389408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01196) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004739) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2021-02-18 |