| NPI | 1801067608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2020-0099) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-02473) |
| 363A00000X Physician Assistant (Licence: OK PA 2030) | |
| 363AS0400X Physician Assistant, Surgical (Licence: PA MA057426) | |
| 363AS0400X Physician Assistant, Surgical (Licence: OH 50.002757) | |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2023-10-16 |