| NPI | 1184167157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6556) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.2023) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2023-05-05 |