| NPI | 1568746139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110011222) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2013-0072) |
| 363A00000X Physician Assistant (Licence: AZ 6672) | |
| 363A00000X Physician Assistant (Licence: KS 15-02485) | |
| 363A00000X Physician Assistant (Licence: IL 085-004036) | |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2025-08-18 |