| NPI | 1831665173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7593) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 11880) |
| 363A00000X Physician Assistant (Licence: WA PA61389715) | |
| 363A00000X Physician Assistant (Licence: MA PA101136) | |
| Enumeration Date | 2018-10-14 |
| Last Update Date | 2024-11-08 |