| NPI | 1851473961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-1588) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-1588) |
| 363AM0700X Physician Assistant, Medical (Licence: WA PA10003288) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2024-07-01 |