| NPI | 1205377306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55556) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005032RX) |
| 363A00000X Physician Assistant (Licence: NM PA2019-002) | |
| 363A00000X Physician Assistant (Licence: NY 024606) | |
| 363A00000X Physician Assistant (Licence: PA MA061706) | |
| Enumeration Date | 2017-03-09 |
| Last Update Date | 2023-12-11 |