| NPI | 1326271503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: WI 3616) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA21829) |
| 363A00000X Physician Assistant (Licence: MA PA3814) | |
| 363A00000X Physician Assistant (Licence: DC PA030778) | |
| 363A00000X Physician Assistant (Licence: NY 015056) | |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2023-05-26 |