| NPI | 1588776694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA18063) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007452RX) |
| 363A00000X Physician Assistant (Licence: NC 0010-09096) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-06-09 |