| NPI | 1184603656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA21197) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002580) |
| 363A00000X Physician Assistant (Licence: IA 001671) | |
| 363A00000X Physician Assistant (Licence: KS 15-01137) | |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2023-03-07 |