| NPI | 1801105705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 21609) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA1830) |
| 363A00000X Physician Assistant (Licence: TX PA16296) | |
| 363A00000X Physician Assistant (Licence: WA PA61276920) | |
| 363AM0700X Physician Assistant, Medical (Licence: AR P-T1014) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA21609) | |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2023-02-16 |