| NPI | 1760876387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA 311747) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2015-005) |
| 363A00000X Physician Assistant (Licence: TN 2891) | |
| 363A00000X Physician Assistant (Licence: MS PA00261) | |
| Enumeration Date | 2015-03-20 |
| Last Update Date | 2019-06-11 |