| NPI | 1669660221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA1703) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA05764) |
| 363A00000X Physician Assistant (Licence: MI 5601004715) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2020-01-13 |