| NPI | 1124732623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10615) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 62351) |
| Enumeration Date | 2023-01-09 |
| Last Update Date | 2025-01-06 |