| NPI | 1801122478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NV PA1285) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA MA054215) |
| Enumeration Date | 2009-11-02 |
| Last Update Date | 2021-01-26 |