| NPI | 1396264925 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 9701) | 
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 54841) | 
| Enumeration Date | 2017-09-14 | 
| Last Update Date | 2023-07-21 |