| NPI | 1154162352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11594) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 14257283-1206) |
| Enumeration Date | 2024-06-03 |
| Last Update Date | 2026-05-06 |