| NPI | 1366189524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11199) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 63309) |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2026-01-02 |