| NPI | 1780036392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 60663) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-008460) |
| 363A00000X Physician Assistant (Licence: FL PA9112674) | |
| 363A00000X Physician Assistant (Licence: SC 2572) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA9112674) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2023-04-20 |