| NPI | 1467478925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0002456) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2017-0020) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 6675) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2024-01-25 |