| NPI | 1194972489 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6341) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2012-0064) |
| 363A00000X Physician Assistant (Licence: VA 0110003083) | |
| 363A00000X Physician Assistant (Licence: OK 1747) | |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2021-08-03 |