| NPI | 1053033506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10191) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PR 1476) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2024-01-03 |