| NPI | 1467524579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56952) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0003617) |
| 363A00000X Physician Assistant (Licence: NC 0010-10717) | |
| 363A00000X Physician Assistant (Licence: PA OA002154) | |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA052800) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2024-02-29 |