| NPI | 1366435869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 2705) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52085) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 2705) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2024-08-06 |