| NPI | 1417108481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA2006) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014236-1) |
| 363AM0700X Physician Assistant, Medical (Licence: CT 002162) | |
| 363A00000X Physician Assistant (Licence: CA 55433) | |
| 363A00000X Physician Assistant (Licence: NC 0010-07239) | |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2023-09-05 |