| NPI | 1598105207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MD C07082) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: CA PA23191) |
| 363AM0700X Physician Assistant Medical (Licence: NJ 25MP00301200) | |
| 363AM0700X Physician Assistant Medical (Licence: PA MA055711) | |
| 363AM0700X Physician Assistant Medical (Licence: NV PA 1434) | |
| Enumeration Date | 2013-06-26 |
| Last Update Date | 2020-10-27 |