| NPI | 1487197141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 58118) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 6562) |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9109931) | |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2024-02-25 |