| NPI | 1356894554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ TP8846) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 3285) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2021-11-11 |