| NPI | 1811316706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA215743) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06239) |
| 363A00000X Physician Assistant (Licence: FL PA9107823) | |
| 363A00000X Physician Assistant (Licence: CA 61677) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9107823) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2023-11-21 |