| NPI | 1174996870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 6613) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL pa9109201) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2022-07-21 |