| NPI | 1508821281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NV PA-C0156) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NV PA895) |
| 363AM0700X Physician Assistant Medical (Licence: AZ 2937) | |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2011-09-01 |