| NPI | 1326320052 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60276548) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: LA 304668) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA PA54168) | |
| 363A00000X Physician Assistant (Licence: IL 085004106) | |
| 363A00000X Physician Assistant (Licence: OR PA157792) | |
| 363A00000X Physician Assistant (Licence: IN 10001396A) | |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2023-10-11 |