| NPI | 1073613261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 10263) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00476) |
| 363A00000X Physician Assistant (Licence: NY 015623-1) | |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2024-07-18 |