| NPI | 1962096636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA218896) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2408) |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2024-03-25 |