| NPI | 1053650416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10524) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA pa 21502) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2024-08-29 |