| NPI | 1942729363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7059) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010889) |
| 363A00000X Physician Assistant (Licence: NY 027862) | |
| 363A00000X Physician Assistant (Licence: CA 54863) | |
| 363A00000X Physician Assistant (Licence: FL PA9115386) | |
| 363A00000X Physician Assistant (Licence: WA PA61567557) | |
| Enumeration Date | 2017-09-18 |
| Last Update Date | 2026-05-29 |