| NPI | 1497007926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 5519) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22535) |
| 363A00000X Physician Assistant (Licence: NM PA2014-0048) | |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2018-03-17 |