| NPI | 1396130605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1625) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA62121) |
| 363A00000X Physician Assistant (Licence: UT 13247622-1206) | |
| 363AM0700X Physician Assistant, Medical (Licence: NV PA1625) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2024-04-10 |