| NPI | 1508332149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA58151) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001258) |
| 363A00000X Physician Assistant (Licence: FL PA9117380) | |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2024-06-06 |