| NPI | 1093467219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10167) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 112202) |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2024-04-14 |