| NPI | 1063631760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5672) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 003413-1) |
| 363A00000X Physician Assistant (Licence: TX PA00667) | |
| 363AM0700X Physician Assistant, Medical (Licence: NM NMPA20070013) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2022-07-21 |