| NPI | 1730459389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID 1075) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AK 1010) |
| 363A00000X Physician Assistant (Licence: WA 60593479) | |
| 363A00000X Physician Assistant (Licence: HI 673) | |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2023-12-12 |