| NPI | 1093371759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56608) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002711A) |
| 363AM0700X Physician Assistant, Medical (Licence: IN 10002711A) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA15641) | |
| Enumeration Date | 2019-05-17 |
| Last Update Date | 2023-12-27 |