| NPI | 1225306343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1630) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA OA002709) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA055029) | |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00284900) | |
| Enumeration Date | 2011-12-03 |
| Last Update Date | 2017-01-05 |