| 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 |