| NPI | 1982925301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA207501) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014584-1) |
| 363A00000X Physician Assistant (Licence: PA MA054809) | |
| 363A00000X Physician Assistant (Licence: HI AMD -- 581) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2022-07-11 |