| NPI | 1306577473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WY PA1261) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 2791) |
| 363AM0700X Physician Assistant, Medical (Licence: SC 5692) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 10-14831) | |
| 363AM0700X Physician Assistant, Medical (Licence: ND 0943) | |
| Enumeration Date | 2022-06-21 |
| Last Update Date | 2025-11-17 |