| NPI | 1396026225 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA13229) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0003335) |
| 363A00000X Physician Assistant (Licence: MA PA100991) | |
| 363A00000X Physician Assistant (Licence: WA PA60595611) | |
| 363A00000X Physician Assistant (Licence: GA 12651) | |
| 363A00000X Physician Assistant (Licence: AZ 10646) | |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2024-10-25 |