| NPI | 1346937059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 10211) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR PA-1410) |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2024-06-15 |