| NPI | 1932155785 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8237) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA07842) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 8237) | |
| 363A00000X Physician Assistant (Licence: MN 12503) | |
| 363A00000X Physician Assistant (Licence: GA 003988) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-05-17 |