| NPI | 1467653790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00910) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9113088) |
| 363A00000X Physician Assistant (Licence: WA PA61581028) | |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2024-09-27 |