| NPI | 1942493523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 3812) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 270015-1206) |
| 363AS0400X Physician Assistant, Surgical (Licence: UT 270015-1206) | |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2020-09-08 |