| NPI | 1902204340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0008241) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 7734) |
| 363A00000X Physician Assistant (Licence: NC 0010-12772) | |
| 363A00000X Physician Assistant (Licence: DC PA031097) | |
| 363A00000X Physician Assistant (Licence: CA PA52917) | |
| 363A00000X Physician Assistant (Licence: SC PA3404) | |
| 363A00000X Physician Assistant (Licence: VA 0110-008469) | |
| 363A00000X Physician Assistant (Licence: MO 2022042041) | |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2025-12-08 |