| NPI | 1124044722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10002493A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01041) |
| 363A00000X Physician Assistant (Licence: NM PA2019-0006) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2023-06-07 |