| NPI | 1386825800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1446) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA05502) |
| 363AM0700X Physician Assistant, Medical (Licence: MD C03702) | |
| 363AM0700X Physician Assistant, Medical (Licence: NH 1446) | |
| Enumeration Date | 2007-11-27 |
| Last Update Date | 2021-11-01 |