| NPI | 1386764116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1390) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601004975) |
| 363A00000X Physician Assistant (Licence: CA 53283) | |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2023-03-07 |