| NPI | 1205123791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PAO8148) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085009000) |
| 363A00000X Physician Assistant (Licence: IA 117261) | |
| 363A00000X Physician Assistant (Licence: MD C0008698) | |
| 363A00000X Physician Assistant (Licence: WY PA1087) | |
| 363A00000X Physician Assistant (Licence: CT 5909) | |
| 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-117666) | |
| 363A00000X Physician Assistant (Licence: ME PA2462) | |
| 363A00000X Physician Assistant (Licence: PA MA054886) | |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2025-10-01 |