| NPI | 1952681397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA183936) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 1099139) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2022-08-12 |