| NPI | 1972168045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA203025) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA61152129) |
| Enumeration Date | 2019-05-04 |
| Last Update Date | 2025-09-25 |