| NPI | 1093084931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1385) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 016558) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60650168) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA003740) | |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2021-07-15 |