| NPI | 1285002931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 8907) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA7552) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2023-03-23 |