| NPI | 1649422999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 019353) |
| 363A00000X Physician Assistant (Licence: MA 6036) | |
| 363A00000X Physician Assistant (Licence: CA 53340) | |
| 363AM0700X Physician Assistant, Medical (Licence: CT 3929) | |
| Enumeration Date | 2008-10-17 |
| Last Update Date | 2022-07-21 |