| NPI | 1134901671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 10570) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA.PA.61484555) |
| Enumeration Date | 2023-10-18 |
| Last Update Date | 2024-10-03 |