| NPI | 1790922326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 4586) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013081) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA60447504) | |
| Enumeration Date | 2009-01-20 |
| Last Update Date | 2023-04-13 |