| NPI | 1952863011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7604) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0007621) |
| 363A00000X Physician Assistant (Licence: WA PA61373859) | |
| 363A00000X Physician Assistant (Licence: GA 11876) | |
| 363A00000X Physician Assistant (Licence: MA PA100594) | |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2024-08-21 |