| NPI | 1295296879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7916) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 208800000X Urology (Licence: AZ 7916) | |
| 363A00000X Physician Assistant (Licence: CO PA.0009531) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2026-06-29 |