| NPI | 1245979558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AZ 9198) |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2022-07-10 |