| NPI | 1720331333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9121415) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 14271263-1206) |
| 363AM0700X Physician Assistant, Medical (Licence: VA 110011733) | |
| 363AM0700X Physician Assistant, Medical (Licence: OH 50.010433) | |
| 363AM0700X Physician Assistant, Medical (Licence: ID 8081901) | |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA0009722) | |
| 363AM0700X Physician Assistant, Medical (Licence: MO 2026006929) | |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 11638) | |
| 363AM0700X Physician Assistant, Medical (Licence: IL 85.012007) | |
| 363AM0700X Physician Assistant, Medical (Licence: AL 2830) | |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2026-08-19 |