| NPI | 1154368793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 2690) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 2690) |
| 363AS0400X Physician Assistant, Surgical (Licence: AZ 2690) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2024-11-04 |