| NPI | 1972909661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA174814) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA174814) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2024-08-16 |