| NPI | 1356424782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60636968) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-01458) |
| 363A00000X Physician Assistant (Licence: AK 917) | |
| 363A00000X Physician Assistant (Licence: CO 1736) | |
| 363AM0700X Physician Assistant, Medical (Licence: CO 1736) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0001736) | |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2025-01-20 |