| NPI | 1124446695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4998) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 136112) |
| 363A00000X Physician Assistant (Licence: WI 8763) | |
| 363A00000X Physician Assistant (Licence: CT 6577) | |
| 363A00000X Physician Assistant (Licence: NH 1115) | |
| 363A00000X Physician Assistant (Licence: UT 14259841-1206) | |
| 363A00000X Physician Assistant (Licence: CO PA0009563) | |
| 363A00000X Physician Assistant (Licence: RI PA00754) | |
| 363A00000X Physician Assistant (Licence: FL PA9113875) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2026-02-28 |