| NPI | 1912247776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 1717) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA54170) |
| 363A00000X Physician Assistant (Licence: TX PA09023) | |
| Enumeration Date | 2013-02-15 |
| Last Update Date | 2023-12-28 |