| NPI | 1790295277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA PA60947899) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 55119) |
| 363A00000X Physician Assistant (Licence: AZ 10601) | |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2024-11-25 |