Individual
NHI DAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3930 HOWARD HUGHES PKWY STE 270, LAS VEGAS, NV 89169-0906
(800) 834-2420
Mailing address
3930 HOWARD HUGHES PKWY STE 270, LAS VEGAS, NV 89169-0906
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
02/07/2017
Last updated
05/26/2021
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