| NPI | 1265673891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT MED-PAC-LIC-86814) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60677484) |
| 363A00000X Physician Assistant (Licence: AZ 4367) | |
| 363A00000X Physician Assistant (Licence: WI 2529 - 023) | |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2021-12-14 |