| NPI | 1427242775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052626) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002098) |
| 363A00000X Physician Assistant (Licence: VA 0110003063) | |
| 363A00000X Physician Assistant (Licence: CA 20394) | |
| 363A00000X Physician Assistant (Licence: NY 013479) | |
| 363A00000X Physician Assistant (Licence: WI 2355-023) | |
| 363AM0700X Physician Assistant Medical (Licence: TX PA06354) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2011-11-08 |