| NPI | 1073067823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 11656917-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 140757) |
| 363A00000X Physician Assistant (Licence: MN 13080) | |
| 363A00000X Physician Assistant (Licence: ND PAC0791) | |
| 363A00000X Physician Assistant (Licence: DE C5-0001079) | |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2022-03-01 |