| NPI | 1972900199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA66171) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 8218-23) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA12120) | |
| 363AM0700X Physician Assistant, Medical (Licence: IN 10001774A) | |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2025-09-05 |