| NPI | 1063702116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64279) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0006468) |
| 363A00000X Physician Assistant (Licence: NV PA0604) | |
| 363A00000X Physician Assistant (Licence: IL 085003971) | |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2024-05-02 |