| NPI | 1306971684 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MT MT1222417) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10004973) |
| 363A00000X Physician Assistant (Licence: CO PA.0008939) | |
| 363A00000X Physician Assistant (Licence: AZ 10898) | |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2024-12-17 |