| NPI | 1750426276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA210036) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00173600) |
| 363AM0700X Physician Assistant, Medical (Licence: UT 8219448-1206) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2023-12-05 |