| NPI | 1215117122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 138960) |
| 363A00000X Physician Assistant (Licence: WA PA60685346) | |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2024-07-25 |