| NPI | 1255963880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 032497) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02794) |
| 363A00000X Physician Assistant (Licence: WA PA61027649) | |
| 363AM0700X Physician Assistant, Medical (Licence: KS 15-02794) | |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA61027649) | |
| 363AS0400X Physician Assistant, Surgical (Licence: WA PA61027649) | |
| 363AS0400X Physician Assistant, Surgical (Licence: KS 15-02794) | |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2025-03-13 |