| NPI | 1992102917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA170690) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2014-11-20 |
| Last Update Date | 2024-04-01 |