| NPI | 1245552074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 7971040) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61659218) |
| 363A00000X Physician Assistant (Licence: AZ 4441) | |
| Enumeration Date | 2010-02-21 |
| Last Update Date | 2025-09-02 |