| NPI | 1871964676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 60969) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV 6263) |
| 363AM0700X Physician Assistant, Medical (Licence: NV PA1676) | |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2023-01-20 |