| NPI | 1376635581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: AZ 7043) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: WY 312) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2024-02-07 |