| NPI | 1649365289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 9118662) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA839) |
| 363A00000X Physician Assistant (Licence: SD 1537) | |
| 363AM0700X Physician Assistant, Medical (Licence: NV PA839) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-01-24 |