| NPI | 1972019149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA191997) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60962035) |
| Enumeration Date | 2017-12-23 |
| Last Update Date | 2024-11-18 |