| NPI | 1871915173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58295) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA13844) |
| 363A00000X Physician Assistant (Licence: WA PA61074810) | |
| 363A00000X Physician Assistant (Licence: NV PA2312) | |
| 363A00000X Physician Assistant (Licence: AZ 5605) | |
| 363A00000X Physician Assistant (Licence: FL PA9113288) | |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2024-02-02 |