| NPI | 1356850267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 6901) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA189876) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2024-04-18 |