NPI | 1427025170 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ PA2018-0089) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 090408) |
363AM0700X Physician Assistant, Medical (Licence: MT 59062) | |
Enumeration Date | 2006-03-01 |
Last Update Date | 2021-04-09 |