| NPI | 1356779656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6369) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 51217) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2021-12-15 |