| NPI | 1336827443 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10456)  | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 001696-P.A.)  | 
| Enumeration Date | 2023-07-10 | 
| Last Update Date | 2024-09-12 |