| NPI | 1023695525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8321) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 450) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2025-02-07 |