| NPI | 1063151249 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9250) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61477339) |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2024-08-30 |