| NPI | 1952874240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61000) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 9490) |
| 363A00000X Physician Assistant (Licence: CO PA.0009488) | |
| 363A00000X Physician Assistant (Licence: TX PA17038) | |
| 363A00000X Physician Assistant (Licence: OH 50.005831RX) | |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2025-11-06 |