| NPI | 1255547287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2787) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA152859) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-04-22 |