| NPI | 1093432098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: AZ 9453) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 9453) |
| Enumeration Date | 2022-10-20 |
| Last Update Date | 2024-05-30 |