| NPI | 1386406650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 10262) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-05-07 |