| NPI | 1851828784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118166) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NM PA2017-0031) |
| 363AM0700X Physician Assistant, Medical (Licence: NM PA2017-0031) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA 58886) | |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2024-02-21 |