| 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 |