| NPI | 1962694976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA01462) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60072217) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2023-11-21 |