| NPI | 1255736435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 7249) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 9169697-8906) |
| 363AM0700X Physician Assistant, Medical (Licence: UT 9169697-1206) | |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2022-06-27 |