| NPI | 1336958883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10947) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2025-10-22 |