| NPI | 1790955086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9393) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: RI PA00991) |
| 363A00000X Physician Assistant (Licence: PA MA053788) | |
| 363A00000X Physician Assistant (Licence: OH 50.005254RX) | |
| 363A00000X Physician Assistant (Licence: NC 0010-01284) | |
| 363A00000X Physician Assistant (Licence: MI 5601012373) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2024-05-10 |