| NPI | 1023445483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58201) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2014-0011) |
| 363A00000X Physician Assistant (Licence: IL 085004674) | |
| 363A00000X Physician Assistant (Licence: FL PA9109679) | |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2022-03-08 |