| NPI | 1891191037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 031893) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005377) |
| 363A00000X Physician Assistant (Licence: NC 0010-05292) | |
| 363A00000X Physician Assistant (Licence: GA 7921) | |
| 363A00000X Physician Assistant (Licence: SC 2198) | |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0005377) | |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05292) | |
| 363AM0700X Physician Assistant, Medical (Licence: SC 2198) | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2024-09-19 |