| NPI | 1952951030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA219557) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60995910) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2024-05-17 |