| NPI | 1407121809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 9606) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 8241324-1206) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2023-03-23 |