| NPI | 1982796553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 9871) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA PA17993) |
| 363A00000X Physician Assistant (Licence: NC 0010-15465) | |
| 363A00000X Physician Assistant (Licence: WA PA61668606) | |
| 363AM0700X Physician Assistant, Medical (Licence: CO PA.0009117) | |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA17993) | |
| 363AM0700X Physician Assistant, Medical (Licence: MA PA101471) | |
| 363AM0700X Physician Assistant, Medical (Licence: HI AMD-951) | |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2025-08-09 |