| NPI | 1699224170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10195) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005114) |
| 363A00000X Physician Assistant (Licence: NC 0010-06771) | |
| 363A00000X Physician Assistant (Licence: CA 61278) | |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2024-07-15 |