| NPI | 1962042556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 64345) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363A00000X Physician Assistant (Licence: OR PA203141) | |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2026-03-26 |